Did Ronald Reagan Have Alzheimer's Disease While in Office?

It has long been rumored that President Reagan suffered from Alzheimer's Disease years before it was diagnosed in 1994, five years after he left office.

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CLAIM

Ronald Reagan, who was diagnosed with Alzheimer's Disease five years after he left the presidency, was actually suffering from the disease while he was in office.

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ORIGIN

The publication in 2018 of a tell-all book about the Trump White House in which aides are reported to have questioned President Trump’s mental stability has revived longstanding rumors holding that Ronald Reagan suffered from Alzheimer’s Disease during his presidency. He was diagnosed with the condition, but not until 1994, five years after leaving office.

Reagan was 69 when he won his first presidential election. Trump was 70, making him the oldest person to be elected to the presidency (excluding Reagan’s re-election at 73). Trump was given a clean bill of cognitive health in January 2018 by White House physician Dr. Ronny Jackson, who had tested him for cognitive impairment and said he had no concerns about the president’s mental fitness.

Reagan’s doctors said much the same thing while he was in office despite the former president’s memory lapses and bouts of confusion in public, most visibly during the 1984 presidential debates and his 1990 Iran-Contra testimony. Incidents such as these led to speculation that he was undergoing a gradual mental decline that those around him didn’t want to admit. A 1987 article in the New Republic posed the troubling question outright: “Is Reagan Senile?”

That was precisely what CBS News reporter Lesley Stahl was asking herself during a 1986 visit with a president she would later describe in her 2000 memoir, Reporting Live, as “shriveled” and verging on catatonic.

“Reagan didn’t seem to know who I was,” she wrote. “He gave me a distant look with those milky eyes and shook my hand weakly. Oh, my, he’s gonzo, I thought.” But a few minutes later, he snapped out of it and from that point on seemed perfectly fine. When asked, White House aides admitted to Stahl that they had witnessed similar episodes.

Even Reagan’s own son, Ron, sensed something was wrong at the time. He wrote in his 2011 book, My Father at 100: A Memoir, that he first became concerned that “something beyond mellowing” was afflicting his father three years into Reagan’s first term. Of the latter’s bumbling debate performance against Walter Mondale in 1984, the younger Reagan observed:

At 73, Ronald Reagan would be the oldest president ever re-elected. Some voters were beginning to imagine grandpa — who can never find his reading glasses — in charge of a bristling nuclear arsenal, and it was making them nervous. Worse, my father now seemed to be giving them legitimate reason for concern. My heart sank as he floundered his way through his responses, fumbling with his notes, uncharacteristically lost for words. He looked tired and bewildered.

But Ron Reagan isn’t a physician, much less one trained to diagnose the symptoms of Alzheimer’s Disease. His half-brother Michael Reagan vehemently disagreed with Ron’s armchair diagnosis and accused him of trying to “sell out his father to sell books.”

Ron later softened his claims in remarks to the New York Times, insisting he never meant to say his father was suffering from dementia while still in office, but rather that the disease was “likely present in him” long before it was diagnosed. Experts say physiological and neurological changes linked to Alzheimer’s start showing up in the brain years before outward symptoms appear.

However, the physicians who directly attended Ronald Reagan while he was president agreed unanimously that he never displayed signs or symptoms of dementia the whole time he was in office, the New York Times reported in 1997:

…even with the hindsight of Mr. Reagan’s [Alzheimer’s] diagnosis, his four main White House doctors say they never detected any evidence that his forgetfulness was more than just that. His mental competence in office, they said in a series of recent interviews, was never in doubt. Indeed, they pointed out, tests of his mental status did not begin to show evidence of the disease until the summer of 1993, more than four years after he left the White House.

“There was never anything that would raise a question about his ability to function as President,” said Dr. Lawrence C. Mohr, one of Mr. Reagan’s physicians in his second term. “Ronald Reagan’s cognitive function, belief structure, judgment, ability to choose between options, behavior and ability to communicate were totally and completely intact.”

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He “never forgot appointments, misplaced or lost things, where he put his glasses, never forgot to put his hearing aids in, never forgot to put his contact lenses in, and these are things he did for himself,” Dr. Mohr said. “I saw him saddle and bridle horses at the ranch and later put things back exactly where they belonged.” And Mr. Reagan, the doctors stressed, was punctual, never depressed and had no difficulty with language or understanding what was going on around him.

Although no cognitive tests were administered to Reagan during his time in office (his doctors saw no need for them), he did begin receiving annual mental and psychological assessments in 1990, after undergoing surgery to remove a blood clot in his brain. The four-hour battery of tests, which would have detected signs of dementia, found nothing amiss for the first three years they were administered. “All parameters for his age absolutely were within the normal range,” one of Reagan’s doctors said. It was Reagan himself who announced the diagnosis of Alzheimer’s in 1994.

There were certainly no indications of dementia (age, perhaps, but not dementia) when the 81-year-old former president delivered a 35-minute speech at the 1992 Republican National Convention, a performance Washington Post reporter Bob Woodward described as “flawless.”

It must also be said that given that the average life expectancy of a patient diagnosed with Alzheimer’s Disease is eight to 10 years, Reagan, who died in 2004 (10 years after his diagnosis), would have been extraordinarily long-lived for an Alzheimer’s patient if he was already suffering from the disease, as some claim, in 1984.

Two academic studies, one published in 1988 and the other in 2015, analyzed transcripts and recordings of Reagan speaking in debates and press conferences to see if his speech patterns betrayed otherwise imperceptible signs of cognitive decline.

The first, which compared Reagan’s speech patterns to those of other politicians,found that Reagan had “significantly higher levels of cognitive impairment scores” than other subjects in the study (including President Carter and Vice President Mondale). The second found that changes in Reagan’s speaking patterns known to be associated with the onset of dementia were detectable “years before clinical diagnosis.”

But although these findings indicate that Reagan did display subtle linguistic signs of cognitive decline while still president, they are experimental and do not suffice to push back the post-presidency diagnosis of Alzheimer’s into his time in office. Visar Berisha, assistant professor of science and hearing at Arizona State University and the lead researcher in the 2015 study told us:

While the language complexity declines we observed are consistent with what you may expect to see in individuals with early signs of dementia, it is impossible to make any conclusive diagnosis based on our study. It’s certainly possible that President Reagan deliberately simplified his language because he found it to be politically advantageous.